- Humana (Hallandale Beach, FL)
- …ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members ... optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or...health issues. + Monitor and maintain awareness of utilization and conducts outreach based on acuity to assess… more
- Molina Healthcare (FL)
- …**Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- HCA Healthcare (Fort Lauderdale, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... to HCA established policies, practices, efficiencies; and effectiveness of clinical Case Management , Utilization Management , and Social Work functions within… more
- CVS Health (Tallahassee, FL)
- …with the Behavioral Health , Pharmacy, Member Outreach, Care Management , National Quality Management , Utilization Management , Compliance, ... health outcomes. * Leverage extensive knowledge of health care delivery system, utilization management...departments to integrate social, behavioral , and physical health and improve clinical program execution. * In collaboration… more
- MyFlorida (Monticello, FL)
- …Identifies students at risk for pregnancy, STDs, substance abuse, and social and behavioral health issues. Refers those students in need of further care. ... acute and emergency care to ill/injured students; identification of social, behavioral , economic, and medical health risks; medication administration; operation… more
- Highmark Health (Tallahassee, FL)
- …Therapeutics Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior ... and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Bluestone Physician Services (Orlando, FL)
- …determinants of health , manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone ... with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management … more
- Elevance Health (Fort Lauderdale, FL)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
- HCA Healthcare (Gainesville, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... benefits and changes in the various benefit plans, both in the terms of health management and financial implications to physicians, , and patients and families… more
- Elevance Health (FL)
- …patients, patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more